By Theresa A. Veach, Donald R. Nicholas, and Marci A. Barton Published by Brunner-Routledge, New York, 2002 255 pages, $34.95 (Hardcover) Cancer and the Family Life Cycle is a nicely organized work that integrates six phases of the family life cycle with six defined stages of cancer treatment. The authors have created narratives for the single young adult, newly forming couple, the family with adolescents, the family launching children and the family in later life as they move through diagnosis, treatment, rehabilitation, survival, recurrence/advanced disease and end of life care. This guide is written for practitioners who work with cancer patients and their families in settings such as hospitals, nursing homes and hospice, as well as private practice settings. The book reinforces the importance of early psychosocial assessment and interventions along the continuum of illness and provides a framework for conceptualizing the impact of cancer on the family system and individual family members. Chapter 1, “Introduction and Purpose,” provides interesting history on the perception of cancer since the 1800's. The evolution of the illness is explored as it changed from a shameful, hopeless diagnosis to a treatable disease impacting multidimensional aspects of patient and family life. This ongoing evolution is reflected in some of the complex constructs and language presented in this guide. For example, phrases such as “cancer as a new family member” (p. 23), “married couples who have had cancer” (p. 159), “cancer to be kept in its place” (p.135) are woven through the text and seem to represent the ongoing struggles to establish a language and conceptual framework that set boundaries around the illness and its influences. This same evolving language impacts the perception of family who are alternately described as “part of the team” and as the “unit of treatment.” How we see the role of family influences the therapeutic formulation and interventions. This book does a fine job of discussing the implications of boundaries and rules of communication within families; it misses an opportunity to do the same in the area of our language as clinicians. Each chapter of this guide is similarly organized. There is an overview of medical, treatment, existential and psychosocial aspects and case examples for each life cycle phase. The case examples integrate genograms, diagnostic interview, assessment and interventions. Tables help coordinate life cycle stage with the following factors: life cycle tasks, cancer's potential disruption to the system, psychosocial interventions and specific topics of communication. Figures describe the emotional process of transitions as families are asked to adjust and adapt boundaries, rules, roles and communication patterns consequent to diagnosis and treatment realities. The case examples are rich with suggested interventions ranging from speaker/listener communication techniques; rituals; and structural, problem solving, group, behavioral and mind-body interventions. Cultural and diversity aspects of the patient/family experiences are not discussed; instead, clinicians will need to integrate this aspect of assessment into the valuable constructs that are provided. This practitioner guide is a useful clinical tool. It represents an ideal wherein patients and families are afforded an initial biopsychosocial assessment, ongoing interventions, options for home care and end-of-life care. The guide can empower clinicians to intervene with patients and families, and encourage specific advocacy efforts to enhance the quality and availability of these important services.
The British Journal of Dermatology publishes original articles on all aspects of the biology and pathology of the skin. Originally the Journal, founded in 1888, was devoted almost exclusively to the interests of the dermatologist in clinical practice. However, the rapid development, since the 1950s, of research on the physiology and experimental pathology of the skin has been reflected in the contents of the Journal, which now provides a vehicle for the publication of both experimental and clinical ethical research and serves equally the laboratory worker and the clinician. To bridge the gap between laboratory and clinic the Journal publishes reviews of recent advances in such aspects of dermatology as laboratory research, contact dermatitis, therapeutics and drug reactions. Other regular features include concise communications, case reports, book reviews, correspondence, news and notices, and selected society proceedings.
Quality of life in epilepsy: beyond seizure counts in assessment and treatment . Edited by gus a baker and ann jacoby. (Pp 316, £38.00). Published by Harwood Academic Publishers, Amsterdam, 2000. ISBN 90 5823 121 6. The issue of quality of life in epilepsy has developed enormously over the past 10 years. Although this is still rather belated in relation to other conditions where the issue has been around for much longer, there is a healthy debate ongoing about what indeed is quality of life and it is likely that no answer to this question will ever be forthcoming. Nevertheless, in terms of health outcome research, there is a place for quality of life measurement. Epilepsy, perhaps more …
